Smoking Still Kills…in So Many Ways

Seven million tobacco deaths per year.

Today, May 31, is World No Tobacco Day, declared by the World Health Organization (WHO) to bring attention to the health problems caused by smoking. According to the WHO fact sheet on tobacco,

“Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890,000 are the result of non-smokers being exposed to second-hand smoke.”

When nurses smoked at the nurses’ station.

It’s amazing to me how far we’ve come in a relatively short time in curbing smoking. When I first started working in hospitals, nurses would be smoking at the nurses’ station; shift report was often in a smoke-filled room; patients and visitors were allowed to smoke as long as there was no oxygen tank in the room. And I always hated sitting in the airline seat that was the dividing row from the smoking section—as if a small sign on the seat made a difference in keeping the smoke at bay!

Some resources.

This year, the focus is on smoking as a leading cause of cardiovascular disease—second only to hypertension. Here are some articles from AJN, plus resources that provide information about the mulitple negative health effects […]

2018-05-31T12:27:31-04:00May 31st, 2018|personal health practices, Public health|1 Comment
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The Risks and Benefits of Transfusion Therapy

Potential complications of transfusions.

Photo © GARO / PHANIE / agefotostock

If your patient develops mild jaundice or thrombocytopenia two weeks after a blood transfusion, would you consider their transfusion history an important part of your assessment?

When I think of monitoring a patient who is receiving a blood transfusion, I think primarily about watching for a hemolytic transfusion reaction or circulatory overload. To me, that means keeping a close watch during the transfusion and for about 24 hours afterwards. Yet “classic” hemolytic reactions and volume overload are not the only potential complications of blood therapy. Delayed reactions can occur days or even weeks after you’ve run through your saline flush and disposed of the blood bag.

Update of current transfusion practices.

In this month’s AJN, Margaret Carman and colleagues provide readers with an update of current practices in transfusion therapy. In “A Review of Current Practice in Transfusion Therapy,” the authors survey the benefits and risks of fresh whole blood (used today primarily in military or disaster settings) and blood components—red blood cells, plasma, cryoprecipitate, and platelets. […]

2018-05-29T11:19:05-04:00May 29th, 2018|Nursing, patient safety, Patients|0 Comments
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June Issue: Hearing-Impairment and Hospitalization, Gaucher Disease, an Early Mobility Protocol, Giving and Getting Report, More

“The problem is the insidious way personal smartphones divert and fracture our attention. If you don’t take work home with you, why is it okay to bring home to work?” —Kathleen Bartholomew, MN, RN, author of this month’s Viewpoint

The June issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Understanding the Hospital Experience of Older Adults with Hearing Impairment

Older hospitalized adults with hearing impairment may be labeled confused, experience heightened fear and anxiety, or misunderstand the plan of care. This qualitative study assessed the hospital experience of hearing-impaired patients in order to formulate suggestions for improving nursing care.

CE: Understanding the Nurse’s Role in Managing Gaucher Disease

The author discusses the epidemiology and pathophysiology of Gaucher disease—a lysosomal storage disorder that can affect the spleen, liver, bones, bone marrow, and central nervous system—as well as recent advances in screening, diagnosis, and management.

Cultivating Quality: The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients

The authors present their quality improvement initiative to establish an NP-led early mobility protocol aimed at reducing uncomplicated postsurgical spine patients’ length of hospital stay and eliminating […]

2018-05-25T08:48:44-04:00May 25th, 2018|Nursing|0 Comments
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What the Patient Knew: Communication and Patient Safety

Anticipating emergencies.

by rosmary/via Flickr

At the start of every shift after receiving report, I take a moment to consider what emergencies I might anticipate for my particular patient in our PICU. Monitor for excessive bleeding in a liver failure patient. Monitor for an altered neurological status in a patient with a head bleed. I try to envision how I would start CPR in the room if required. I try to be thorough in checking that all my emergency equipment is present and working. I try to keep patient safety at the forefront of my mind and priorities.

I came to work one day and received report about my 9-year-old patient who was post-operative day one from a planned craniofacial surgery. He would remain nasally intubated with eyes sutured shut for a few days until the swelling had reduced, and then would return to the OR to be extubated and to have the eye sutures removed. I’d had patients like him before and felt he would be very easy to keep safe, especially given that per handoff report, he was comfortably sedated and not overly agitated when he did briefly waken with nursing care.

A patient’s question.

As I got to know him through the first couple hours of my shift, I found that he was indeed comfortably sedated though […]

2018-05-24T10:08:09-04:00May 24th, 2018|Nursing, patient safety, Patients|0 Comments
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Sleepless Nurses

“If I couldn’t even figure out what goes into my lunch box, how could I possibly have multitasked . . . on a busy unit?”

Awake for 40 hours.

Photo by Jeff Greenberg. The ImageWorks.

I recently had the disorienting experience of being awake for 40 hours. This had to do with a family member’s interminable emergency department visit, a 3 a.m. car breakdown, and a post-ED MRI and medical visit.

I’ve never been up for 40 hours in my life. I didn’t pull “all-nighters” in school before exams, and never worked longer than a double eight–hour shift. Partying the night away wasn’t in my DNA. So this experience was strange and new, and something I pondered over for days afterward.

An ‘otherworldly’ state.

By the time I’d been up for 24 hours straight, I was operating at a level about two beats behind everyone around me. Physically, I felt a little off-balance, as though I might fall if I didn’t step carefully. My brain seemed mired in muck, and I found myself trying to recall what I knew about depleting bodily stores of ATP. Preparing to return to work around hour 26, I stared into my lunch box. I couldn’t remember what food I was supposed […]

2018-05-21T08:29:35-04:00May 21st, 2018|Nursing|4 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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